Chapter 12: Intro to Personality Disorders and Borderline Personality Disorder Flashcards

1
Q

personality disorder

A

persistent pattern of emotions, cognitions and behaviours that results in enduring emotional distress for the person affected and for others and may cause difficulties with work and relationships.

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2
Q

dimensional model of personality disorders (PDs)

A

a model where PSd are extreme versions of otherwise normal personality variations

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3
Q

categorial model of PD

A

model that suggests PDs are completely different from someone who is psychologically healthy.

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4
Q

there is a distinction between PD problems of ___ (Dimension) and problems of ___ (category)

A

there is a distinction between PD problems of DEGREE (Dimension) and problems of KIND (category)

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5
Q

model that characterizes the basic personality dimensions

A

Big 5-factor model:

  • openness to experience
  • agreeableness
  • extraversion
  • conscientiousness
  • neuroticism.
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6
Q

differences between the cluster A and B and C disorders

A

A; “odd” or “eccentric disorders: schizotypical, schizoid and paranoid disorders

B: dramatic disorders like antisocial, boarderline, histrionic and narcissistic PDs

C: anxious/hearful disorders: inludes avoidant, dependent and obsessive comulsive PDs.

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7
Q

the DSM5 uses the ___ model to characterize PDs

A

categorical model. Some dimensional models have been suggested though, it could give flexibility in diagnosis.

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8
Q

common element of cluster B personality disorders

A

impulsivity. cluster B PDs are often characterized as emotional, erratic and dramatic.

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9
Q

problems with the statistics behind PDs

A

high comorbidity. some PDs may be misdiagnosed because theyre associated with other mood disorders and dependece on substances.

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10
Q

differences in men and women PD

A

men diagnosed with PDs tend to display traits characterized as more aggressive, structured, self-assertive, and detached

Women diagnosed with PDs tend to display traits characterized as more submissive, emotional, and insecure

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11
Q

___ PD is present more often in males, and ___ PD is present more often in females.

A

ANTISOCIAL PD is present more often in males, and DEPENDENT PD is present more often in females.

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12
Q

criterion gender bias

A

the criteria for a disorder may themselves be biased (ex/ some symptoms only women can feel)

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13
Q

assessment gender bias

A

the assessment measures and the way they are used may be biased.

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14
Q

___ PD is characterized by irresponsible and reckless behaviour

A

antisocial

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15
Q

____ PD is characterized by excessive emotionality and attention seeking

A

histrionic

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16
Q

people with ___ PD are excessively mistrustful and suspicious of others without any justification

A

people with PARANOID PERSONALITY DISORDER.

they assujme other people are out to harm or tirkc ehm, and therefore they tend not to confide in others.

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17
Q

defining characteristic of someone with paranoid personality disorder

A

pervasive, unjustified, distrust.

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18
Q

T/F people with paranoid PD are delusional

A

false. although individuals with paranoid PD are very suspicious of others, their suspiciousness does not reach delusional proportions.

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19
Q

causes for paranoid PD (Cluster A)

A

1) genetics
2) relative with schizophrenia
3) childhood trauma
4) culture: immigrants, refugees, pioneers and the elderly are thought to be particularly susceptible because of their unique experiences.

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20
Q

people with paranoid PD often do not seek help because they do not trust people. What must be established for proper help

A

a therapeutic alliance. they must try to provide an atmosphere conducive to develping a sense of trust. they often use CBT. `

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21
Q

this cluster A PD shows a pattern of detachment from social relationships and a very limited range of emotions in interpersonal situations

A

schizoid PD. They seem cold, aloof and indifferent to other people. They tend to lack emotional expressiveness.

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22
Q

potential causes of schizoid PD

A

1) childhood shyness
2) abuse and neglect
3) lower density of DA receptors are correlated with higher levels of detachment. This is also seen in people with autism

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23
Q

treatment for schizoid PD

A

1) therapist needs to point out the value in social relationships
2) may need be taught emotions felt by others.
3) social skills training

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24
Q

people with ____ PD are typically socially isolated, and behave in strange ways while holding odd beliefs

A

with SCHIZOTYPAL PD. considered to be on a continuum with schizophrenia. They also tend to have ideas of reference: believing that everything must be about them (ex/ everyone on the bus is looking at them). They may also have magical thinking where they believe in teleportation or time travel.

25
Q

possible causes for schizotypal PD

A

a woman’s exposure to influenza may predispose her child to schizotypal PD and schizophrenia.

26
Q

treatment of schizotypal PD

A

treating younger pts who have symptoms of schizotypal PD with some combination of antipsychotic medication, cognitive behaviour therapy and social skills training in order to avoid the onset of schizophrenia is proving to be a promising prevention strategy.

27
Q

antisocial PD is part of the cluster ___

A

cluster B

28
Q

___ PD are characterized by dramatic individuals who have a history of failing to compley with social norms

A

antisocial PD. they chamr, manipulate and often tend to teal, be impuslive and deceitful. tend to lack remorse and do not get nervous in morally tricky situations.

29
Q

6 aspects of the psychopathy check list

A

1) superficial charm
2) grandiose sense of self-worth
3) pathological lying
4) conning/manipulation
5) lack of remorse or guilt
6) callous/lack of empathy.

  • associated with antisocial PD.
30
Q

differnece between psychopaths that become incarcerated and those who do not

A

IQ. findings suggest that having a higher IQ may help protect some people from developing more serious problems.

31
Q

rather than childhood psychopathy or antisocial PD, children who demonstrate a violation of social norms ( like someone with antisocial PD) are considered to have ___ disorders

A

conduct disorders

32
Q

two “types” of conductive disorders

A

1) childhood onset type

2) adolescent onset type.

33
Q

what is psychoticism

A

Not to be confused with psychotic disorders like schizophrenia, psychoticism is a personality characterized by high impulsivity and low empathy

34
Q

T/F: there is a genetic component to antisocial PD

A

true. there is a genetic influence on both antisocial PD and criminality.

most likely a gene-environment interaction: genetic factors may be important only in the presence of certain environmental influences like orphanages or bad peer groups. also poor family dynamics riddled with legal, marital, abuse, neglect, and psychiatric problems.

35
Q

two major neurobiological theories of antisocial PD/psychopathy

A

1) underarousal hypothesis

2) fearlessness hypothesis.

36
Q

underarousal hypothesis for antisocial PD

A

psychopaths have abnormally low levels of CORTICAL AROUSAL, exhibiting a U shaped relation between arousal and performance on the Yerkes-Dodson curve.

people with either very high or very low levels of arousal tend to experience negative affect and perform poorly in many siutations.

the abnormally low levels of cortical arousal characteristic of psychopaths are primary cause of their antisocial and risk-taking behaviours; they SEEK STIMULATION TO BOOST THEIR CHRONICALLY LOW LEVELS OF AROUSAL.

solidifed by evidence: psychopaths show excessive theta waves even when awake.

37
Q

the underarousal hypothesis of antisocial PD gave rise to the ___ ___ hypothesis

A

cortical immaturity hpothesis

38
Q

cortical immaturity hypothesis of antisocial PD

A

holds that the cerebrl cortex of psychopaths is at a relatively primitve stage of development. may explain why they are childlike and impulsive.

their less-matured cerebral cortices prevent proper inhibition and impulse control.

also characterized by theta waves

39
Q

fearlessness hypothesis of antisocial PD

A

psychopaths possess a higher threshold for experiencing fear than most other individuals.

-lowered galvanic skin responses (LOW AUTONOMIC REPONSES) are seen in people with psychopathic dtencies, even when exposed to a painful electric shock. Shows a blunted response to emotional stimuli

THIS MIGHT BE DUE TO THE SMALLER AMYGDALA AND LESS ACTIVE FRONTAL LOVES

40
Q

what enzyme is deficient in people with violent outbursts /psychopathic people

A

a deficiency in monoamine oxidase A. This gene is located on the X chromosome

41
Q

the behavioural inhibition system is thought to be located in the septal ____ area of the brain, and involves the ___ and ___ NT systems

A

the behavioural inhibition system is thought to be located in the septal HIPPOCAMPAL area of the brain, and involves the NORADRENERGIC and 5HT NT systems

42
Q

WHICH two systems in the brain are thought to be implicated in people with antisocial PD/psychopathy

A

1) behavioural inhibitions sstem
2) reward system.

psychopaths may have a depressed behavioural inhibiton system, and an enhanced reward system.

43
Q

explain how psychopaths process reward and punishment

A

once psychopaths set their sights on a reward goal, they are less likely than non psychopaths to be deterred despite the signs that the goal is no longer achievable.

they have a failure to abandon an unattainable goal

44
Q

one of the major problems with treating people with antisocial personality disorder

A

they rarely identify themselves as needing treatment.

45
Q

treatments for antisocial personality disorder

A

cognitive behavioural therapy and early intervention for children showing antisocial tendencies
-programs that combine the behavioural approaches just described with efforst to improve family relationships and provide services to the families in their communities are reporting some success.

46
Q

essential feature of borderline personality disorder.

A

s a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts

  • often described as attention seeking
47
Q

key symptoms of borderline PD

A

1) intense fear of abandonmnet
2) challenges with interpersonal relationships
3) self-damaging behaviours and low self-esteem
4) history of suicidal or para-suicidal behaviours.
5) feeling little to no control over emotions
6) IMPULSIVITY (common feature across cluster B personality disorders) –> seen by drug abuse and self-mutilation

48
Q

which gender is affected by borderline PD more?

A

75% of diagnosed are female. But this may be due to bias: less experienced clinicians tend to diagnose BPD, and white low SES females tend to be diagnosed with BPD more frequently.

49
Q

which other disorder is comorbid wit BPD

A

80% of people with BPD have major depression, and approximately 10% had bipolar II disorder. There is also a high prevalence for eating disorders: 25% meet criteria for bulimia, 20% meet criteria for anorexia.

  • 64% diagnosed with at least one substance use disorder
50
Q

childhood ____ and ___ is highly implicated as contributing to BPD

A

childhood abuse and neglect is highly implicated as contributing to BPD. Girls are reported to be 2-3 times as likely as boys to be sexually abused.

51
Q

biopsychosocial model of BPD

A

suggests that BPD results from a combination of biological predisoposition (ex/ genetic causes, high emotional sensitivity), and stressful triggering events (sexual and physical abuse as a child)

52
Q

principle of multifinality

A

the idea that various outcomes may stem from similar beginnings. Ie, traumatic events can lead to PTSD, CPTSD, BPD or DID.

53
Q

pharmacotherapy appraoches to treatments of BPD

A

BPD individuals have been seen to respond positvely to antidepressants and antipsychotics (quitiapine). and lithium

54
Q

cognitive behavioural therapy for BPD

A

dialectical behaviour therapy: involves helping people cope with the stressors that seem to trigger suicidal behaviours and other maladaptive responses. (SKILLS TRAINING)

  • weekly individual sessions provide support,and patients are taught how to identify and regulate their emotions.
  • mindfulness, interpersonal, distress tolerance, emotional regulation and dialectical thinking skills are cultivated)
  • tried to increase problem solving skills and fostering a sense of self-efficacy

couples therapy also seems to be really helpful (not for impulsive subtype)

55
Q

three subtypes of borderline patients.

A

1) impulsive subtype
2) identity disturbance subtype
3) affective cluster (tholse with marked mood swings and difficulty controlling anger)

56
Q

which subtype of BPD will not benefit from couples therapy

A

impulsive subtype.

57
Q

Bipolar disorder vs BPD

A

Key differences:
–Bipolar disorder includes alternating emotional extremes week to week(i.e., periods of depressive symptoms and mania) rather than day to day or moment to moment
–BPD generally includes more rapid changes between extreme moods
–In BPD the mood changes are usually associated with interpersonal situations/triggers; not so in bipolar disorder
–Mood disorder (bipolar) vs. personality disorder (BPD)

58
Q

borderline empathy paradox

A

Individuals with BPD have been described both as having enhanced empathyand impaired levels of empathy•Appears to depend on measuring state-based empathy or situational factors

•When acutely stressed or distressed, can display reduced empathy

59
Q

In DBT, how are their treatment priorities set?

A

sets priorities on target behaviours:

1) prioritizes life threatening behaviour
2) second priorit is therapy-interfering behaviours
3) third priority is quality of life interfering behaviours